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Policies and Procedures

14. Vacation and Leave


EXHIBIT I

POLICY ON RESIDENT VACATION AND LEAVES
http://www.ecu.edu/cs-dhs/gme/customcf/policies/VacationAbsence.pdf

The scheduling of vacations, the granting of leaves of absence and the provision of holiday time
are administrated within the individual residency programs under this common policy.

Annual Vacation Leave
Three weeks of vacation is provided annually. Vacation time for residents will begin accruing
immediately upon employment. The resident's preference for vacation time shall be considered
whenever possible.
Sick Leave
Twelve days of sick leave annually are available for all residents and is provided to help protect
against economic hardships due to illnesses.
Holidays
The Organization observes nine (9) holidays. Work schedules within each program shall be
adjusted to ensure that each resident has equitable holiday time.
Leaves of Absence (Paid or Unpaid) Policy
A. Personal Leave of Absence. (Not covered by the Family and Medical Leave Act of 1993).
The Program Director may grant a resident a personal leave of absence without pay not to
exceed thirty (30) calendar day. Residents may request a leave of absence through their
Program Director and complete required forms in the Graduate Medical Education
Office. The thirty (30) calendar day period may be extended by approval of the Vice
President of Human Resources as circumstances warrant. Accrued vacation and holidays
must be used before requesting personal leave.
B. Illness or Disability (including Pregnancy) Leave of Absence. (Not covered by the
Family and Medical Leave Act of 1993).
1. Illness. If a resident with six months of service, but less than 12 months develops
an illness or disability (including pregnancy), Program Directors may grant a
leave of absence based on the medical necessity. The resident will report to the
Graduate Medical Education Office to complete the appropriate paperwork before
the leave of absence begins. Statements from the resident's attending physician
substantiating the need for a leave and justifying the length of time requested may
be required by the Program Director. Leaves of this nature will not exceed three
(3) months.
2. Illness Determined by Insight or Occupational Health Service. If a resident
develops an illness or disability and the Program Director determines that
continued work may jeopardize the health of the employee, co-workers, patients,
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or the public, the Program Director may require the resident to be examined by
the Occupational Health Services. Based upon the results of the examination, the
Program Director may choose to place the resident on a leave of absence in
accordance with advice from the Occupational Health Services' physician. The
resident will report to the Graduate Medical Education Office to complete the
appropriate paperwork before the leave of absence begins. In some instances, the
InSight Program may be utilized instead of Occupational Health Services, as
applicable.
In either case 1 or 2 (above), when the resident notifies the Program Director that
he/she is ready to return to work, the Program Director may require the employee
to be examined by the Occupational Health Services and may require a letter from
the attending physician stating the resident may return to work.
C. Medical or Family Leave. Residents may be granted Medical or Family Leave in
accordance with the Family and Medical Leave Act of 1993.
Who's Eligible? Residents who have worked at least 1250 hours in the previous 12
month period may request a leave of absence through their Program Director for up to 12
weeks during the fiscal year. The resident must have been employed by VMC for a total
of at least 12 months prior to the beginning of the leave. If a resident is not eligible for
Medical or Family Leave, the resident may be eligible for a Personal Leave of Absence
of a Leave of Absence for Illness, as described in paragraphs A and B above.
A 12 month period is defined as the payroll fiscal year for purposes of the Family and
Medical Leave policy.
Residents requesting a leave of absence of any kind must provide the Program Director a
written notice by completing a Family and Medical Leave Certification form at least 30
days prior to the beginning of the leave, whenever possible. The Family and Medical
Leave Certification form may be obtained from the Graduate Medical Education Office.
A resident's leave request may be denied if the resident fails to complete a Family and
Medical Leave Certification form. Once a leave is approved, any time undertaken, paid
or unpaid, counts toward the total 12 week period required by the law.
Extensions for any leave of absence beyond the 12 week period must be approved by the
Vice President of Human Resources. The extended leave will be based on information
provided by the resident on a Family and Medical Leave form as to the purpose for the
medical need.
Family Leave includes the birth of a child, care of newborn child, adoption or foster care
of a son or daughter.
Medical Leave includes serious illness of the resident or the need to care for a spouse,
son, daughter (including step-children, and other qualifying dependents living in the
household) or parent with a serious illness based on medical necessity.
1. Medical Leave of Absence (Note: Act requires employers to grant intermittent or
reduced leave, if medically necessary).
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a. Illness or Disability of the Employee (including pregnancy). The Act
provides for residents with a "serious illness" which prevents them from
performing their job duties to be granted a leave for up to 12 weeks during
any payroll fiscal year based on medical necessity. This 12 week leave
period will include all sick leave residents are required to use. A leave of
absence may be extended up to six (6) months, depending on the medical
need and must be approved by the Vice President of Human Resources.
The extended leave will be based on information provided by the resident
on a Family and Medical Leave Certification form as to the purpose for
the medical need.
A serious illness is defined as a health condition that involves inpatient
care in a hospital, hospice, residential medical facility, or continued
treatment by a health care provider. A serious illness includes
psychological illnesses as well as physical illnesses.
The Hospital has the right to request a second or third opinion at the
Hospital's expense and certification of illness, which would include the
medical facts of the illness. The Program Director may also request
subsequent recertification of the illness. For leave of absences longer than
2 weeks (including pregnancy) residents will be required to submit a
statement form the physician releasing the resident to return to work.
b. Residents with a serious illness may be granted an intermittent or reduced
leave based on medical necessity. Intermittent leave is a leave taken in
separate blocks of time due to a single illness or injury, not to exceed 12
weeks (480) hours within a 12 month period (Example: Employee takes
six weeks leave for surgery, returns to work for four weeks, and later
needs another three weeks leave for chemotherapy.)

Reduced leave is a leave schedule which allows residents to reduce usual
working hours in a workday or workweek based on medical necessity.

2. Family Leave of Absence (Note: Act does not require an employer to grant
intermittent or reduced leave for family leave for child birth or care of newborn
child, adoption or foster care.)
a. Serious Illness of a Child, Spouse or Parent. Residents may be granted a
12 week leave, reduced or intermittent leave of to care for a spouse, child
(including step-children and other dependents living in the household) or a
parent with a serious illness based on medical necessity.
A serious illness is defined as a health condition that involves inpatient
care in a hospital, hospice, or residential medical facility, or continued
treatment by a health care provider. A serious illness includes
psychological illnesses as well as physical illnesses.
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A spouse is a husband or wife as defined or recognized under State law for
purposes of marriage.
A child (son or daughter) is a biological, adopted or foster child, a step-
child, a legal ward, or a child of a person standing in loco parentis, who is
either under age 18 or older and incapable of self-care because of a mental
or physical disability. (Loco parentis includes someone with day-to-day
responsibilities to care for and financial support of a child. A biological or
legal relationship is not necessary.)
A parent is a biological parent or an individual who stands or stood in loco
parentis to an employee when the employee was a child.
Residents are required to use any accrued vacation and any holiday time
for illness of a child, spouse or a parent, prior to any unpaid leave.
Utilization of accrued sick time is not permitted. This paid time off would
be inclusive of the total 12 week period.
b. Childbirth. Residents may be granted a leave of absence following
childbirth for a one-time continuous 12 week period. This 12 week period
will include any leave time for illness or disability of the employee during
or after pregnancy. The resident will be required to use any accrued
vacation and any holiday time after the illness or disability during the
leave for childbirth.
The resident must provide the Program Director and the Office of
Graduate Medical Education with a written notice at least thirty (30) days
prior to the beginning of the expected leave. This leave of absence must
be taken within the 12 month period beginning on the date of birth, unless
the resident is disabled prior to the birth, in which case C-1 of this policy
would apply. Utilization of accrued sick leave will be for illness or
disability of the resident only.
c. Adoption or Foster Care. Residents may be granted a one-time continuous
leave for up to 12 weeks for adoption or foster care of a child. The
resident must provide the Program Director and the Office of Graduate
Medical Education a written notice at least thirty (30) days prior to the
beginning of the expected leave whenever possible. This leave of absence
must be taken within the 12 month period beginning on the date of
placement in the home, unless absence from work is required prior to
placement in order for the adoption or placement to proceed (e.g.
employee is required to attend counseling sessions, court appearances, etc.
related to the case.)
Residents are required to use any accrued vacation, sick and holiday time
during the leave for the adoption or foster care of a child.
When both parents are employed with VMC, the two may be granted no
more than a total of 12 weeks leave (e.g. six weeks each).
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D. Extensions for any leave of absence beyond the 12 week period must be requested and
approved by the Program Director, Graduate Medical Education Office and Vice
President of Human Resources with a maximum of 12 months.
E. While on leave of absence, a resident may continue his/her current insurance premiums
provided necessary arrangements for payment of the premium are made with the Payroll
Department. (Details of an employee's insurance coverage during a leave of absence are
available in the Compensation and Benefits Department.)
If the resident does not return from leave because of reasons other than the continuation,
recurrence, or onset of a serious health condition affecting the resident, the resident's
spouse, child or parent, or some other reason beyond the resident's control, the resident
must reimburse Vidant Medical Center for premiums paid by Vidant Medical Center
during the resident's leave of absence.
F. A resident's leave of absence may be canceled and employment terminated according to
the following:
* The resident accepts employment with another employer before the expiration of
the leave.
* The resident fails to return to work at the expiration of the leave or 12 week
period without prior approval for extension of the leave from the Program
Director and/or Vice President of Human Resources.
* The resident, in the case of medical leave, fails to provide certification of the
medical necessity for the leave within 15 days after the employer's request for it,
or fails to provide recertification of the medical necessity for the leave within a
reasonable time (not to exceed 15 days) after the request for it (unless it is not
practicable for the resident to do so despite the resident's diligent, good faith
efforts.)
Pregnancy Wellness Program
The Organization is committed to the quality of life of employees through wellness and
prevention. The Pregnancy Wellness Program is a major focus of the wellness efforts.
Therefore, flexible working hours are permitted for pregnant residents to attend pregnancy
wellness classes and prenatal physician appointments. Residents are responsible for
coordinating, in advance, the time off and make-up time with their Program Directors.
Residency Program Guidelines for Parental Leave
PURPOSE: The Graduate Medical Education Committee recognizes the need to allow residents
the flexibility of scheduling time away from the work place relating to parental leave have been
established:
A. The Residency Program Director must be advised at the earliest possible time of a
resident's pregnancy and anticipated delivery date. To the greatest extent possible light
duty rotations will be scheduled for late pregnancy and post delivery.
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B. Consistent with the Vidant Medical Center Personnel Policies and with the approval of
the Residency Program Director, the resident may use accrued sick days and vacation
time. This is paid leave as long as sick and vacation days are available and all hospital
benefits continue.
C. Leave beyond this time will be leave without pay. Employee benefits, particularly health
insurance, may be maintained provided the premiums are paid by the resident. All leave
is provided through the Vidant Medical Center benefits program and is therefore subject
to Vidant Medical Center Personnel Policies.
D. In cases of complication in pregnancy, in which leave needs to start before the 38th week,
special arrangements should be made with the Residency Program Director. The resident
should contact the program director as soon as any complications are recognized. In such
cases, the resident may be asked to provide a physician's statement outlining the
circumstances.
E. Absences (to include vacation) beyond the allowable interruption in training as defined
by the certifying body of each of the individual departments may be extended at the end
of the resident's regular training period, i.e. 36 months, 48 months, etc.
F. When placed on leave of absence, the resident may re-enter the program provided the
resident meets the criteria established within the individual departments.
G. Adopting parents or residents requesting paternity leave should use accrued vacation
time. If additional time is requested beyond the accrued vacation time, the Leaves of
Absence Without Pay/Personal Leave of Absence will be applicable.
All guidelines described herein have been approved by the Graduate Medical Education
Policy Committee (GMEPC) and are subject to re-evaluation and modification at any
time. When they are in conflict with policies on leaves of absence of the certifying body
of the various residency training programs, the policies of those groups will be adhered
to.
Funeral Leave
Program Directors may grant time off with pay up to 6 work days (48 hours) per fiscal year but
no more than 3 work days (24 hours) per circumstance to residents for attending to funeral
arrangements, personal affairs of, or attending funeral services for a member of the immediate
family. Immediate family is defined by this Organization as an employee's husband, wife, son,
daughter, mother, father, sister, brother, mother-in-law, father-in-law, son-in-law, daughter-in-
law, grandfather, grandmother, grandson, and granddaughter. Step relatives will be considered
the same as natural relatives for the purpose of this policy. Reasonable proof of death and
funeral attendance shall be supplied by the resident when requested by the Organization.
Military Leave
A. Residents who are members of the North Carolina National Guard or one of the military
reserve components shall be granted time off for required periods of active duty for
training each year. These residents will be granted up to 2 weeks of this time without
loss of pay. Residents desiring military leave must supply their Program Director and the
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Graduate Medical Education Office with a copy of their military orders before the
military leave. Residents who are on military leave with pay shall reimburse the
Organization the military pay received up to an amount equal to their regular
Organizational pay. On return from leave the resident shall present a copy of his military
pay voucher to the Payroll Department. A check will be issued to compensate for any
difference between the military pay and the resident's regular Organizational pay less
travel and living expenses. The resident's time sheet will be coded "Military Leave."
B. Personnel of the Armed Forces of the United States, and those who are subject to and
called upon for military or war duties other than annual active duty for training under the
provision of any state or federal statute or Presidential or Gubernatorial Order, shall be
given a leave of absence (without pay) without loss of continuous service for any periods
of time they are so called. Residents called for active duty must supply their Program
Director with a copy of their military orders before the military leave. The copy will be
forwarded to the Graduate Medical Education Office to become part of the resident's
permanent records.
Court and Jury Duty
Time off with pay shall be granted to any resident summoned for Jury Duty. Should a resident
be notified that he/she is required to attend or be subpoenaed as a witness in any Organizational
related court action, the resident should notify his/her Program Director immediately. The
resident shall receive regular pay and be compensated for travel. Residents who are defendants
in criminal actions, plaintiffs or defendants in civil actions, or subpoenaed in either shall be
given time off without pay or may be granted accrued benefit time at the Program Director's
discretion.

Adopted 2/90; revised 4/96; revised 9/01









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SPECIFICALLY FOR ECU NEPHROLOGY FELLOWS:

Yearly Vacation/Professional/Sick Leave
10 days professional leave (meeting attendance)
12 sick days/year
15 days vacation
It is preferable that vacation be requested 3 months in advance, the minimal time frame
is 1 month in advance in accordance with departmental standards.
It is the fellows responsibility to ensure coverage for conferences such as journal club
or nephrology grand rounds; for transplant clinic and for any conflicts in the on-call
schedule.
It is preferable that vacation be taken in one week blocks on non-hospital months.
However, vacation for a two week block will be permitted under the following
circumstances in accordance with ACGME-RRC guidelines for completion of a
meaningful rotation: One week will be taken during a non-hospital month and the
remaining adjoining week may be taken during a consult or service month by arranging
coverage in a collegial fashion amongst fellows.
Any extenuating circumstances preventing adherence to the above guidelines must be
reviewed and approved by the program director.

Educational/Other Leave
5 days per 2 YEAR FELLOWSHIP to be used for interviews, meetings with
licensing/government/visa issues, etc.
** Any overages constitutes time without pay

Book and Travel
$1500.00 per 2 year fellowship to be used in part or in whole at any time
Any fellow presenter at the following conferences will receive $500.00 and 3 days off to attend
meeting (2 days travel and day of presentation)
o ASN - November
o ATC - May
o ASH - May
Questions re: reimbursement to Elaine Briley and Anita Holley
ECU Nephrology will pay up to $1000.00 towards the purchase of board review DVDs or
registration fee for each fellow to attend a Nephrology board review course of their choosing
once during their fellowship. The fellow may attend in their 1
st
or 2
nd
year of training as long
as appropriate fellow cross-coverage is arranged for any hospital, outpatient, clinic or call
duties. IF the fellow chooses to attend in the fall after they complete fellowship, the
registration must be submitted prior to June 30
th
of their 2
nd
year. Registration for the fall ASN
board review course opens in the preceeding April or May of the same year (verified with ASN
7/06). The payment will be made DIRECTLY from ECU Nephrology Bentzel Fund to the
ASN, not to the fellow (no exceptions). Meals, lodging, airfare will remain the responsibility
of the fellow.

Updated 7/18/06; 4/19/11; 7/1/13